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Contact your local DAV office. They will help you file a claim and stick with you all through the process, because no veteran should have to go at it alone.
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DAV benefits experts are available across the country to help veterans navigate their VA benefits and provide counseling for veterans on claims and appeals—all at no cost to the veteran. Find your office using the locator to the right.
One of the most confusing aspects of filing for service-connected disability compensation is figuring out how the Department of Veterans Affairs establishes a rating. Below we will show you how VA calculates disability ratings so you can be better informed when discussing and making decisions about your claim.
How does VA decide a rating?
If VA rates a single condition, your rating is the rating for that single condition, but most veterans are rated for multiple conditions. This rating for multiple conditions is called a “combined” rating.
One of the major misconceptions is that combined simply means added together, which is not true as the VA uses what is known as a combined ratings table. This means that a person’s efficiency is determined first by the most disabling—or highest individually rated condition—and then by less disabling conditions ranked in order of severity.
A veteran may receive a letter from VA notifying them that they have two service-connected disabilities, TBI and a back injury, rated at 50% each. Normally, 50% plus 50% would equal 100%, but this veteran’s total disability rating is listed as 80%.
This is how the combined ratings table works:
In this case, the VA takes 100 (representing a whole efficient person) and subtracts the highest individually rated condition (TBI at 50%). This means the veteran is initially considered 50% disabled and 50% efficient.
100% whole efficient person – 50% = 50%
The veteran’s back injury is also rated at 50%, but no longer at 50% of the whole efficient person. Instead, the back injury rating is subtracted from the remaining efficient person.
50% remaining efficient person – 50% = 25%
So only 25% (for the back injury) is added to the first 50% (for the TBI).
50% (TBI) + 25% (back injury) = 75% combined disability rating
VA rounds the combined disability rating up to the nearest 10, so 75% becomes 80% total disability.
For additional information on how VA rates disability claims, you can visit their benefits site here.
A veteran should first receive notification from VA that the claim was received—which may take up to two weeks after filing a paper form or within a matter of hours if the claim was submitted electronically.
A VA representative will then review your claim to determine if any additional information is needed. They will contact the appropriate sources—whether it’s you, a medical professional or government agency—to collect that information. This evidence gathering portion can be the longest part of the claims process, and may require further medical examinations.
Once it is determined that all necessary evidence has been received, the claim receives a review and a final rating decision is recommended. If you are using DAV as your appointed representative, they will review the recommendation and return it to the VA. Then a final determination is made and a claim decision packet will be mailed to you containing the rating decision and additional information regarding your disability rating.
If you are satisfied with your decision, you need take no further action. However, if you are not satisfied with any part of the outcome, you have the right to appeal the VA’s ruling.
It is possible in some cases to simply gather additional information recommended by your DAV benefits specialist and request re-adjudication of the claim. This may be faster than filing a formal appeal.
A DAV specialist can also help you file a formal appeal if that is necessary, and as of 2017 there are now three paths a veteran can take to do so: taking their appeal directly to the Board of Veterans’ Appeals; requesting a higher-level VA adjudicator to decide their case; or file a supplemental claim with new evidence.
Veterans have one year from the date of the VA notification letter to appeal a claims decision.
VA has implemented new regulations to require the mandated use of standard claim and appeal forms. The following forms are mandated by VA for filing claims and appeals on or after March 24, 2015.
VA Form 21-0966 Intent to File a Claim for Compensation and/or Pension, or Survivors Pension and/or DIC
VA Form 21-526EZ Application for Disability Compensation and Related Compensation Benefits
VA Form 20-0995 Decision Review Request: Supplemental Claim
VA Form 20-0996 Decision Review Request: Higher-Level Review
VA Form 10182 Decision Review Request: Board Appeal (Notice of Disagreement)
VA Form 21P-534 Application for Dependency and Indemnity Compensation, Survivors Pension and Accrued Benefits by a Surviving Spouse or Child (Including Death Compensation if Applicable)
VA Form 21P-527EZ Application for Veterans Pension
VA Form 21P-527 Income, Net Worth, and Employment Statement
For the above forms and all other official VA forms visit: http://www.va.gov/vaforms/default.asp